Healthcare Provider Details

I. General information

NPI: 1639793854
Provider Name (Legal Business Name): CHRISTINA D'ARCO SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E MADISON ST
LOMBARD IL
60148-3602
US

IV. Provider business mailing address

720 E MADISON ST
LOMBARD IL
60148-3602
US

V. Phone/Fax

Practice location:
  • Phone: 630-977-9266
  • Fax:
Mailing address:
  • Phone: 630-977-9266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA D'ARCO
Title or Position: OWNER
Credential: M.A. CCC-SLP
Phone: 630-977-9266